妊娠期糖尿病女性产后早期盆底肌功能状况分析

The Pelvic Floor Muscle Function in Women with Gestational Diabetes Mellitus in Early Postpartum

目的:探讨妊娠期糖尿病(GDM)女性产后早期盆底肌功能状况,为产后盆底功能障碍性疾病的防治提供一定依据。方法:回顾性分析2017年1月至2021年6月于首都医科大学附属北京友谊医院分娩,并于产后6~8周在我院进行盆底功能筛查女性的临床资料,对176例GDM产妇、741例糖耐量正常(NGT)女性产后早期盆底肌功能进行比较。GDM组根据治疗方式进一步分为饮食运动+单纯饮食运动治疗组(A1组,170例)和胰岛素治疗组(A2组,6例)。结果:①本研究约95.4%的女性产后早期盆底电生理指标出现异常,78.7%的女性产后早期盆底手测肌力出现异常。②GDM组产后早期快速收缩最大值及手测肌力明显低于NGT组(P<0.05);A2组其耐力收缩平均值较A1组更低(P<0.05)。③GDM是女性产后早期多数盆底肌电指标异常的独立危险因素。结论:GDM女性产后早期盆底肌功能受损更严重,表明GDM可能是女性产后早期盆底功能受损的高危因素,应予以重视。

Objective:To explore the function of pelvic floor muscle in early postpartum women with gestational diabetes mellitus(GDM),so as to provide a basis for the prevention and treatment of postpartum pelvic floor dysfunction.Methods:A retrospective survey was conducted,and women who gave birth in Beijing Friendship Hospital,Capital Medical University and had an pelvic floor examination at 6-8 weeks after delivery from January 2017 to June 2021 were interviewed.Our study compared the pelvic floor muscle function of postpartum women with176 GDM and 741 normal glucose tolerance(NGT)postpartum women in the early postpartum period.The GDM group was further divided into diet and exercise treatment group(A1 group,170 cases)and diet and exercise+insulin treatment group(A2 group,6 cases)according to treatment methods.Results:①In our study,about 95.4%of all women showed abnormal pelvic floor electrophysiological indicators in the early postpartum period,and 78.7%of women showed abnormal pelvic floor manual muscle strength in the early postpartum period.②The maximum sEMG of rapid contraction and manual muscle strength in the GDM group were significantly lower than those in the NGT group(P<0.05).Compared with A1 group,the average sEMG of endurance contraction in A2group was significantly lower(P<0.05).③GDM was an independent risk factor for the abnormality of most pelvic floor electromyography indicators in early postpartum women.Conclusions:The damage of pelvic floor muscle function in GDM women in the early postpartum period is more serious,indicating that GDM may be a high risk factor for the damage of pelvic floor function after delivery.We should pay more attention to women with GDM.